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| Ingestion of caustic products: About 270 cases
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Ahlam El Ghmari, Kaoutar Ezzouak, Maria Lahlali, Asmae Lamine, Nada Lahmidani, Mounia El Yousfi, Sidi Adil Ibrahimi , Mohammed El Abkari, Dafr-Allah Benajah, Hakima Abid
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Abstract:
:Ingestion of caustic products (CP) is a medical-surgical emergency requiring multidisciplinary management. Upper gastrointestinal endoscopy is the reference examination; it allows for lesion mapping, prognosis orientation and choice of the appropriate therapeutic strategy.The aim of our work is to describe the epidemiological, clinical, radiological, endoscopic and evolutionary aspects of CP ingestion in a Moroccan population.Patients and Methods: This is a descriptive retrospective study between June 2001 and August 2020 including all patients admitted to the emergency room for CP ingestion. All patients were given endoscopy on admission, which classified caustic oesophageal and gastric lesions according to their severity and extent.Results: A total of 270 patients were collected. The mean age was 32.8 years [15-90 years]. Sex ratio F/W: 1.2. Psychiatric antecedents were noted in 7.4% (20 cases), represented mainly by depression, a history of heart disease was noted in 27% and diabetes in 21.6%.Ingestion of CP was for autolysis in 58% of cases. The most common CP involved was hydrochloric acid (43%). Digestive endoscopy was performed in 96% (259 patients) with an average delay of 16 hours. It was normal in 81 patients (31%). Among the latter, 60% of the patients had ingested industrialized bleach and the ingestion was accidental in 83% of the cases where the product was unpackaged. Endoscopic lesions found were stage I esophagitis in 19% of cases, stage II in 29.6% and stage III in 9.6% of cases. At the gastric level, caustic gastritis was stage I in 5% of cases, stage II in 14.8% of cases and stage III in 26% of cases. Late complications occurred in some cases as oesophageal stenosis in 10.7% of cases requiring endoscopic dilatation sessions and superinfection of endoscopic lesions in 2 patients. Conclusion: PC ingestion is common especially in young patients with a psychiatric history. Upper endoscopy has a crucial role in the diagnosis, prognosis and orientation of the therapeutic strategy. The ingestion of PC exposes to acute complications (perforation) which can engage the vital prognosis of the patient and in the long term (stenosis).
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